Continuing Professional Development in Rheumatology for Primary Care Clinicians: A Systematic Review

Abstract

Objective. To determine the quality of published rheumatology-focused continuing professional development (CPD) for primary care clinicians (PCCs) for improving the care of patients with rheumatic diseases.Methods. The authors conducted a systematic review of CPD focused on rheumatology topics for PCCs. A librarian systematically searched PubMed, Embase, Web of Science, ERIC, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Sinico. Studies were limited to those conducted in North America after 1993. An extraction form that included the Medical Education Research Study Quality Instrument and the Kirkpatrick levels of learning outcomes was created through an iterative process and applied to the included articles.Results. In total, 725 articles were retrieved, of which 9 were included. Results showed that CPD was directed more at noninflammatory arthritis than inflammatory arthritis. Autoimmune diseases were underrepresented; 4 studies discussed rheumatoid arthritis, and 1 study examined rheumatologic topics broadly. Newer research tended to include multimodal approaches that combined didactic and active learning strategies, showing an evolution toward more active learning. Although online learning is increasingly popular, interventions were predominantly face-to-face, with only a single example of e-learning. Studies were predominantly of moderate quality.Conclusion. Published studies of rheumatology-focused CPD are moving toward more interactive teaching modalities and are typically conducted in person, although virtual options for rheumatology-focused CPD should be explored to improve access to CPD. Autoimmune disease is an uncommon topic in CPD and represents an area for future expansion. Efficacy was difficult to assess given that most of the studies assessed for learner satisfaction, knowledge acquisition, or behavior change, whereas only 1 study focused on patient outcomes.

Social cognitive theory to improve symptom appraisal and help‐seeking among patients with autoimmune rheumatic diseases: A qualitative study

“…Education of healthcare professionals was another important approach advocated by many participants, in view of their delay in primary care and/or non‐rheumatology specialties. This suggests the lack of knowledge of ARDs among non‐rheumatologist healthcare professionals, due largely to the insufficient undergraduate and continuing medical education in rheumatology 30–32 . Education of medical students, primary care.…”

“…This suggests the lack of knowledge of ARDs among non-rheumatologist healthcare professionals, due largely to the insufficient undergraduate and continuing medical education in rheumatology. [30][31][32] Education of medical students, primary care. and other non-rheumatologist healthcare professionals on the suggestive features of ARDs and the importance of early treatment could not only address the unmet need of misdiagnosis and delayed referral, 20,22,23,25,29,[33][34][35][36] but also facilitate a supportive environment for early help-seeking among patients who are already seeking medical attention for ARD associated conditions.…”

An Online Program for Primary Care Practitioners to Enhance Confidence in Ability to Care for Patients With or at Risk of Painful Knee Osteoarthritis

“…We used a standard instrument to evaluate the impact of our program, aligning with a recent systematic review of continuing professional development in rheumatology for PCPs, which identified program evaluation as an area for improvement. 42 In conclusion, we have developed a free online program that improves participants' confidence in their ability to care for patients with or at risk of painful KOA. Whether the impact on improvements in confidence translate into better patient outcomes is an important area of future research.…”

“…We reached a broad group of learners, who were extremely positive about the program, would overwhelmingly recommend it to others, and endorsed plans to implement evidence‐based practices. We used a standard instrument to evaluate the impact of our program, aligning with a recent systematic review of continuing professional development in rheumatology for PCPs, which identified program evaluation as an area for improvement 42 …”

Addressing the Rheumatology Workforce Shortage: Clinician Educators

“…Courses and bootcamps utilizing interactive teaching modalities have been created to support PCPs in this need 12,13 ; however, these may be of moderate quality, based on metrics including increased rheumatology knowledge, change in clinical behaviors, and improved patient outcomes. 14 Through its Education Partner Program, the American College of Rheumatology (ACR) has prioritized content dissemination to PCPs, specialists, and APPs who take care of patients with rheumatic diseases. 15 Clinician educators are central to leading these initiatives aiming to expand the pool of providers who capably deliver care to patients with rheumatic disease (Figure 1).…”